Clinical Results & Dynamic Accommodative Benefits with Laser Anterior Excision (LaserACE) procedure: 18months follow-up using Er:YAG Laser.

AnnMarie Hipsley, Marguerite B. McDonald

Purpose: To evaluate accommodative benefits and dynamic range of visual performance after bilateral LaserACE procedure using VisioLite Er:YAG.

Methods: This retrospective consecutive non-comparative observational study evaluated the LaserACE procedure results over 18months. Outcomes of 67 patients (134 eyes) ages 37-68 included uncorrected distance visual acuity (UCDVA), uncorrected Near Visual Acuity (UCNVA), Uncorrected intermediate visual acuity (UIVA) , accommodative amplitude, and minimum age related accommodative amplitude (MAA) restored. LaserACE® surgery was performed using the VisioLite Er: YAG ophthalmic laser system. IOP results were also recorded. Results were analyzed by iTracey, COAS-HD/DSA Dynamic aberrometry, tonometry and standard refractive diagnostics.

Results: PreOP: NVA: 0.04% J3-J4; 28% J5-J9; 67% J10 or worse. IVA: 19% J3-J4; 55% J5-J9; 25% J10 or worse.DVA:75% 20/15-20/20; 24% 20/25-20/30; 1% 20/40 or worse. 18 months postoperative: NVA: 89% patients J3 or better; 98% patients J5 or better; IVA: 95% patients J3 or better; 100% J5 or better; DVA: 88% 20/15-20/20; 22% 20/25-20/30; 0% 20/40 or worse. Range accommodative amplitude: 2.0-5.5D (SD=0.620623) & was correlated per age group and PreOP MAA; Mean accommodative amplitude across all age groups =3D. Mean Contrast Sensitivity statistically improved (p>0.01) Mean IOP: decreased ave 3.09mmHg. No major complications. All subjects achieved some improvement of quality and quantity of visual performance.

Conclusion: LaserACE procedure with VisioLite Er: YAG laser appears to be a safe and effective procedure for restoring range of visual performance for all distances (near, intermediate, distance) for functional visual tasks. A total postoperative accommodation capacity of approximately 3D was remarkably consistent despite age or PreOP residual capacity. Dynamic Accommodative benefits and Stability was demonstrated in the results over 18 months.